Reflux esophagitis and gastroesophageal reflux disease: a cross-sectional study of gastroesophageal reflux disease patients by age group

The purpose of this study was to explore the relationship between the intensity of acid reflux and severity of esophageal tissue damage in a cross-sectional study of patients with gastroesophageal reflux disease (GERD). Seventy-eight patients with were selected in accordance with the strict 24-hour ambulatory esophageal pHmetry (24h-pHM) criteria and distributed into three age groups: Group A: 14 - 24 years of age. Group B: 25 - 54; and Group C: 55 - 64. The 24h-pHM was carried out in accordance with DeMeester standardization, and the Savary-Miller classification for the diagnosis of reflux esophagitis was used. The groups were similar in 24h-pHM parameters (p > 0.05), having above normal values. For the study group as a whole, there was no correlation between age group and intensity of acid reflux, and there was no correlation between intensity of acid reflux and severity of esophageal tissue damage. However, when the same patients were sub-grouped in accordance with the depth of their epithelial injury and then distributed into age groups, there was a significant difference in esophagitis without epithelial discontinuity. Younger patients had less epithelial damage than older patients. Additionally, although there was a significant progression from the least severe to the moderate stages of epithelial damage among the age groups, there was no apparent difference among the age groups in the distribution between the moderate stages and most severe stages. The findings support the conclusion that the protective response of individuals to acid reflux varies widely. Continued aggression by acid reflux appears to lead to the exhaustion of individual mechanisms of epithelial protection in some patients, but not others, regardless of age or duration of the disease. Therefore, the diagnosis and follow-up of GERD should include both measurements of the quantity of refluxed acid and an assessment of the damage to the esophageal epithelium.

Nevirapine vs efavirenz in virologically supressed patients: Differences in lipoprotein subclasses and inflammatory biomarkers.

Background: The interaction between lipid disturbances and inflammatory markers is not well known in patients on antiretroviral therapy (ART). As nevirapine (NVP) is associated with a better lipid profile than efavirenz (EFV), we investigated the relationships between lipid profiles, lipoprotein subclasses and inflammatory biomarkers in patients with prolonged viral suppression with either NVP or EFV and no obvious clinical inflammation. Methods: 122 clinically stable HIV-infected patients with HIV-1 RNA <20 copies longer than 6 months on NNRTI therapy were studied. 72 (59%) were on EFV and 50 (41%) on NVP. Any potentially inflammatory co-morbid diseases (concurrent viral hepatitis, diabetes, hypertension, chronic liver or renal diseases), or statin treatment, were exclusion criteria. Inflammatory biomarkers included hsCRP, LpPLA2, sCD40L, IL-6, IL-8, t-PA, MCP-1, p-selectin and VCAM-1. Lipoprotein subclass measures (VLDL, LDL, IDL and HDL particle number and size) were obtained by the use of proton nuclear magnetic resonance spectroscopy. Results: 82% were male; median age 45 years. Median CD4 count 550/μL (IQR 324). Median time since HIV diagnosis 96 months (IQR 102) and accumulated time on ART 50 months (IQR 101). Patients on NVP had higher time since HIV diagnosis (126.9 [66.7] vs 91.3 [6.6] months, p=0.008) a prolonged time on ART (89.6 [54.6] vs 62.3 [52.2] months, p=0.01) and were older (47.7 vs 40.7 years, p=0.001) than those on EFV. NVP-treated patients presented increased HDL-c (55.8 [16] vs 48.8 [10.7] mg/dL, p=0.007) and apoA1 levels (153.4 [31.9] vs 141.5 [20.5] mg/dL, p=0.02), and reduced apoB/apoA1 ratio (0.68 [0.1] vs 0.61 [0.1], p=0.003) than EFV-treated patients. No differences in inflammatory markers or lipoprotein subclasses were found between NVP and EFV. In patients with extreme lipid values (less favorable: 75th percentiles of LDL, small/dense LDLp and small HDLp, or more favorable: HDL p75 and apoB/apoA1 ratio p25), no consistent differences in inflammatory biomarkers were found. Conclusions: Patients with prolonged viral suppression on NVP present significantly higher HDL and apoA1 levels and reduced apoB/apoA1 ratios than those on EFV, but no differences were found in lipoprotein particles nor inflammatory biomarkers. Relationships between lipid parameters and inflammatory biomarkers in NNRTItreated patients are complex and do not show a linear relationship in this study.

Livre fait par GILLES LE BOUVIER, dit Le Hérault Berry, où l'on peut « savoir au vray la manière, la forme et les propriétés des choses qu'ilz sont en tous les royaulmes crestiens, et des autres royaulmes » où il s'est trouvé, « de la longueur d'iceulx, des montaignes qui y sont et des fleuves qui y passent ; de la propriété des païs, des hommes, et des aultres choses estranges ».

Premiers mots : « Pour ce que plusieurs gens de diverses nacions et contrées se delectent et prennent plaisir, comme j'ay fait le temps passé, à veoir le monde... ». Derniers mots : «... En ces Espaignes et en Arragon a grant multitude de Sarrazins et de Juifz, qui tiennent terres, maisons et prossessions, et communiquent avecques les crestiens. Et les tiennent les roys, pour le prouffit qu'ilz ont d'eulx ». Suit la rubrique : « Ce livre a fait le roy d'armes de Berry, herault du roy de France, des pays et regions où il a esté en son vivant, avec les fleuves et cités principaulx de toute crestienté. Doxa Theo ». Armoiries.

Estudi relatiu a l’anàlisi de les infraestructures principals considerades en la proposta del Pla Director Urbanístic de Martorell-Abrera.

S’arriba a 4 conclusions de l’anàlisi del PDU estudiat. 1- Respecte al nou traçat de la C-55, s’entén necessari determinat desplaçament en sentit sud que alliberi territori no malmès i de futur creixement.2- Respecte al pont sobre el riu Llobregat, és prioritari per poder connectar dues parts de la població travessada per múltiples infraestructures i elements naturals. 3- Respecte al vial connexió B40-B224, ha de descarregar clarament el trànsit procedent de la zona industrial cap a la A2, oferint sortida cap a la AP7 i la B40, és un eix reconegudament favorable.4- Respecte a l’àmbit de ponent paral•lel a la futura B40 es posa de relleu les potencialitats d’aquesta part del territori com reserva natural, en conseqüència, qualsevol actuació que es pogués plantejar en aquest àmbit, caldria orientar-la des de la perspectiva d’una zona o via de servei de la B40.

Qualidade dos frutos de crambe durante o armazenamento

Em sementes armazenadas sob condições adequadas, a velocidade do processo de deterioração pode ser diminuída, permitindo a conservação da viabilidade das mesmas por período mais prolongado do que o obtido em condições naturais. Objetivou-se no presente trabalho avaliar a qualidade dos frutos de Crambe abyssinica armazenados em diferentes condições ambientais. Foram utilizados frutos de crambe com teor de agua de 6% b.u. Os testes de condutividade elétrica, absorção de água, porcentagem de germinação e índice de velocidade de germinação (IVG) foram realizados no início do experimento (0 meses) e a cada 2 meses, durante um ano. O armazenamento foi realizado em três condições distintas: condição ambiente (26 ± 3 ºC; 55 ± 12% Umidade Relativa - UR), câmara refrigerada do tipo B.O.D. (5 ± 1 ºC; 79 ±5 % UR) e câmara climatizada com aparelho de ar condicionado (18 ± 1 ºC; 53 ± 7% UR). A câmara climatizada (18 ± 1 ºC; 53 ± 7% UR) conserva melhor a qualidade dos frutos de crambe em relação à condição ambiente (26 ± 3 ºC; 55 ± 12% UR) e câmara refrigerada do tipo B.O.D. (5 ± 1 ºC; 79 ± 5% UR). O armazenamento dos frutos por doze meses, nos três ambientes analisados, promove a quebra de dormência das sementes.

Multinational drug corporations, intellectual property rights and the Canadian state : a historical and critical analysis

This study critically analyzes the historical role and influence of multinational drug cotpOrations and multinational corporations in general; the u.s. government and the Canadian state in negotiating the global recognition ofIntellectual Property Rights (IPR) under GATT/NAFTA. This process began in 1969 when the Liberal government, in response to high prices for brand-name drugs amended the Patent Act to introduce compulsory licensing by reducing monopoly protection from 20 to seven years. Although the financial position ofthe multinational drug industry was not affected, it campaigned vigorously to change the 1969 legislation. In 1987, the Patent Act was amended to extend protection to 10 years as a condition for free trade talks with the u.s. Nonetheless, the drug industry was not satisfied and accused Canada of providing a bad example to other nations. Therefore, it continued to campaign for global recognition ofIPR laws under GATT. Following the conclusion of the GATTI Trade-Related aspects of Intellectual Property Rights agreement (TRIPS) in 1991, the multinational drug industry and the American government, to the surprise of many, were still not satisfied and sought to implement harsher conditions under NAFTA. The Progressive Conservative government readily agreed without any objections or consideration for the social consequences. As a result, Bill C-91 was introduced. It abandoned compulsory licenses and was made retroactive from December 21, 1991. It is the contention of this thesis that the economic survival of multinational corporations on a global scale depends on the role and functions of the modem state. Similarly, the existence of the state depends on the ideological-political and socioeconomic assistance it gives to multinational corporations on a national and international scale. This dialectical relation of the state and multinational corporations is explored in our theoretical and historical analysis of their role in public policy.

Looking at The Future of Canadian Copyright in The Rear View Mirror

"L’auteur présente une analyse générale de l’évolution historique et des développements récents du régime des droits d’auteur au Canada. Avec le développement des nouvelles technologies de l’information, et plus spécifiquement de l’Internet, le régime canadien des droits d’auteur nécessiterait d’importantes réformes. L’auteur déplore toutefois les modifications récentes issues de la loi C-60. En effet, selon lui, ces changements ne correspondent pas au régime international proposé par l’Organisation Mondiale de Propriété Intellectuelle. En fait, ceux-ci cadrent beaucoup plus avec la perspective américaine de protection limitative des droits d’auteur. Michael Geist trace d’abord l’historique du développement du régime de protection des droits d’auteur au Canada. Il souligne notamment les modifications législatives importantes de la fin des années 1980 et 1990 qui visaient à renforcer les règles de reconnaissance et de protection des droits que les auteurs canadiens possèdent sur leurs œuvres. Parallèlement, à ces modifications législatives, la Cour Suprême du Canada s’est aussi prononcée sur la question des droits d’auteur en interprétant limitativement la portée de ce régime, facilitant ainsi l’accès des œuvres artistiques au domaine public. L’auteur souligne les divergences et les contradictions entre la conception législative et celle jurisprudentielle de la fonction du régime canadien des droits d’auteur. Le législateur canadien a récemment proposé une nouvelle modification du régime de droits d’auteurs qui consisterait en l’extension des délais obligatoire avant qu’une œuvre couverte par le régime ne soit incluse dans le domaine public. Michael Geist s’oppose à une telle modification et soutient qu’elle entraînerait de nombreuses conséquences négatives pour les auteurs et les artistes canadiens. En effet, cette modification limiterait l’accès des auteurs aux oeuvres antérieures, elle entraverait les opportunités et les capacités commerciales des œuvres canadiennes et restreindrait les domaines de recherche académique. L’auteur aborde par la suite la problématique reliée aux ""Mesures de Protection Techniques"" et à la législation qui les encadre. En analysant les problèmes causés par ces mesures aux États-Unis, il présente leurs effets nuisibles pour les domaines fondamentaux de la liberté de parole et de la recherche académique. Les réformes possibles du régime canadien des droits d’auteur se situent dans une perspective plus ouverte du régime de protection et de promotion des œuvres canadiennes. Ces réformes auraient l’avantage de promouvoir et de protéger les œuvres canadiennes tout en évitant les problèmes causés par les mesures trop limitatives. À ce sujet, l’auteur propose l’établissement d’une bibliothèque digitale nationale, l’abrogation des droits d’auteur de la couronne et un nouveau régime permettant l’utilisation du matériel radiodiffusé de la Société Radio-Canada."

Les débats politiques entourant l’adoption de la Loi sur la sécurité des rues et des communautés : une analyse des représentations

Au Canada, les discours politiques entourant la question des politiques pénales ont parfois été favorables à la répression, et parfois favorables à la réhabilitation et la littérature démontre qu’au cours des années, nous avons toujours nuancé notre approche à l’aide d’une philosophie pénale dichotomique, favorisant le juste équilibre entre ces deux rationalités pénales. Depuis l’arrivée du gouvernement conservateur en 2006 et malgré une baisse de l’activité criminelle enregistrée, l’activité législative en matière criminelle et pénale s’est intensifiée. En 2011, le gouvernement a ainsi déposé le projet de loi C-10, une loi omnibus comprenant 5 volets distincts, chacun mettant en place des changements important sur différentes dimensions du processus criminel ou pénal. L’objet de notre étude consiste, à partir de l’analyse des débats entourant l’adoption de ce projet de loi C-10, à comprendre les représentations du crime, du criminel et de la sanction pénale, et ce à partir de l’analyse documentaire thématique. Le corpus utilisé dans ce mémoire est formé de débats parlementaires ayant eu lieu à la Chambre des communes entre le 20 septembre 2011 et le 6 décembre 2011. Il ressort de notre analyse que la perspective dualiste d’autrefois a disparu au détriment d’une perspective pénale axée sur la protection en favorisant la rétribution, réprobation et la neutralisation. Nos résultats soulignent l’importance de l’émotion et du sensationnel dans les débats, ainsi que l’arrivée d’une pénalité politisée.

Aproveitamento de resíduo de beneficiamento do caulim na produção de porcelanato cerâmico

Nowadays, industries from all sectors have great concerns over the disposition of the residues generated along the productive process. This is not different in the mineral sector, as this generates great volumes of residues. It was verified that the kaolin improvement industry generates great volumes of residue basically constituted of kaolinite, muscovite mica and quartz, which are basic constitution elements to formularisations of ceramics masses to the production of covering of stoneware tiles type. This happens because the methodology applied to the improvement process is still very rudimentary, what causes a very low yield, only ¼ from all the material volume that enters the improvement process, in the end, is marketable. The disposal of this residue, in a general way, causes a very big negative environmental impact, what has justified the researches efforts aiming to find a rational solution to this problem. In this way, the intention of this present work is the utilization of this residue in the manufacture of products to high quality ceramics covering, stoneware tiles in an industrial scale. For this purpose, the influence of the addition of the residue to a standard ceramics mass used by a ceramics sector company, already established in the market, with the intention of verifying the possibility of use of this residue as the mass complementary raw material and even the possible partial or total substitution of one of the components of the mass for the raw material in evidence will be studied. To the accomplishment of this work, the kaolin improvement residue generated by an industry of exploitation and improvement of kaolin, located in the region of Equador-RN, in the levels 1,2,4,8, 16 and 32% will be added to the standard mass already used for the production of stoneware tiles. The raw materials used, kaolin residue and the standard mass, were characterized through DRX, FRX, DTA, TGA and dilatometry. After the sintering of the bodies of test, tests of water absorption, apparent porosity, post burning linear retraction, apparent specific mass and flexural strength (3 point bending) were realized to determinate the technological properties of these materials. The results show the studied residue can be considered raw material of great potential to the industry of floor and ceramics covering of the stoneware tiles type

Retinoic acid prevents ventricular remodelling induced by tobacco smoke exposure in rats

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of Conventional and Resin-modified Glass-Ionomer Liner on Dentin Adhesive Interface of Class I Cavity Walls After Thermocycling

Objective: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling.Materials and Methods: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5 degrees C-55 degrees C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 nun x 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p < 0.05).Results: There was no detectedstatistical difference on bond strength among groups (alpha < 0.05). Confocal microscopy analysis showed a higher mean gap size in group 4(12.5 mu m) and a higher percentage of marginal gaps in the thermocycled groups. The RNIGIC liner groups showed the lowest percentage of marginal gaps.Conclusions: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Marginal adaptation of Class 2 adhesive restorations

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups ( n = 20): ( 1) oblique incremental insertion technique ( control), ( 2) centripetal incremental insertion technique, and ( 3) bulk insertion. The teeth were restored with a total-etch adhesive and micro-hybrid composite resin. The specimens were isolated with nail varnish except for a 2-mm-wide area around the restoration and then thermocycled ( 1,000 thermal cycles, 5 degrees C/ 55 degrees C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores ( 0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests ( P <.05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores ( P =.15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins ( P =.04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques.

Durability of Microtensile Bond to Nonetched and Etched Feldspar Ceramic: Self-adhesive Resin Cements vs Conventional Resin

Purpose: The objective of this study was to evaluate the effect of thermocycling (TC), self-adhesive resin cements and surface conditioning on the microtensile bond strength (mu TBS) between feldspathic ceramic blocks and resin cements.Materials and Methods: Fifty-six feldspathic ceramic blocks (10 x 7 x 5 mm) (Vita Mark II) were divided into groups according to the factors "resin cement" (3 cements) and "surface conditioning" (no conditioning or conditioning [10% hydrofluoric acid etching for 5 min + silanization]) (n = 8): group 1: conditioning+Variolink II (control group); group 2: no conditioning+Biscem; group 3: no conditioning+RelyX U100; group 4: no conditioning+Maxcem Elite; group 5: conditioning+Biscem; group 6: conditioning+RelyX U100; group 7: conditioning+Maxcem Elite. The ceramic-cement blocks were sectioned to produce non-trimmed bar specimens (adhered cross-sectional area: 1 +/- 0.1 mm(2)), which were divided into two storage conditions: dry, mu TBS immediately after cutting; TC (12,000x, 5 degrees C/55 degrees C). Statistical significance was deterimined using two-way ANOVA (7 strategies and 2 storage conditions) and the post-hoc Tukey test (p<0.05).Results: Resin cement and thermocycling affected the mu TBS significantly (p = 0.001). In the dry condition, group 5 (18 +/- 6.5 MPa) presented the lowest values of mu TBS when compared to the other groups. TC decreased the mean mu TBS values significantly (p<0.05) for all resin cements tested (9.7 +/- 2.3 to 22.1 +/- 6.3 MPa), except for the resin cement RelyX U100 (22.1 +/- 6.3 MPa). In groups 3 and 4, it was not possible to measure mu TBS, since these groups had 100% pre-test failures during sectioning. Moreover, the same occurred in group 2 after TC, where 100% failure was observed during thermocycling (spontaneous failures).Conclusion: Hydrofluoric acid etching and silanization of the feldspathic ceramic surface are essential for bonding self-adhesive resin cement to a feldspathic ceramic, regardless of the resin cement used. Non-etched ceramic is not recommended.

Synthesis, characterization and thermal behaviour of solid 2-methoxycinnamylidenepyruvate of some bivalent metal ions in CO2 and N2 atmospheres

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Crystallization and preliminary X-ray diffraction analysis of XAC1151, a small heat-shock protein from Xanthomonas axonopodis pv. citri belonging to the alpha-crystallin family

The hspA gene (XAC1151) from Xanthomonas axonopodis pv. citri encodes a protein of 158 amino acids that belongs to the small heat-shock protein ( sHSP) family of proteins. These proteins function as molecular chaperones by preventing protein aggregation. The protein was crystallized using the sitting-drop vapour-diffusion method in the presence of ammonium phosphate. X-ray diffraction data were collected to 1.65 angstrom resolution using a synchrotron-radiation source. The crystal belongs to the rhombohedral space group R3, with unit-cell parameters a = b = 128.7, c = 55.3 angstrom. The crystal structure was solved by molecular-replacement methods. Structure refinement is in progress.